Kudzivirira uye kutarisira kweIntraoperative Hypothermia - Chikamu 1

Kudzivirira uye kutarisira kweIntraoperative Hypothermia - Chikamu 1

I. Pfungwa ye hypothermia:

• Core tembiricha pazasi 36 × iri hypothermia

• Core tembiricha iri tembiricha mune yemuviri wepamomonary artery, tympanic membrane, esophagus, nasopharynx, rectum uye bladder, nezvimwe.

• Periemarative Hypothermia (INADVERTENTIENTIENTIVETIRAYPOThermia, IPH), nyoro hypothermia inogona kuitika mumakumi mashanu muzana -70% yeanesthesiology uye varwere vanovhiya.

Ii. Hypothermia Grading:

• Clinically, musimboti wekutonhora we 34 ℃ -36 ℃ anowanzo kutaurwa nezvemanyoro hypothermia

• 34 ℃ -30 ℃ SEZVAKASHURE HYPothermia

• 30 ℃ -28 ℃ iri mwero hypothermia

• <20 ℃ yeiyo yakadzika hypothermia

• <15 ℃ Ultra-yakadzika hypothermia

III. Zvinokonzera zvinokonzeresa hypothermia

(I) kuzvikonzera:

A. Zera:

Seniors:  Murombo Armarlation basa (tsandanyama tete, Low mhasuru toni, ropa remuganda, tube contractile straincy yakadzikira, yakaderera Cardievascular Reserve basa).

Vacheche vasati vasvika, vanodzora madiki evacheche:  iyo thermooredory centre inovhurika.

B. FOMED (mafuta emuviri)

Mafuta isimba rakasimba rekupisa insulator, inogona kudzivirira kurasikirwa kwekupisa kwemuviri.

Masero ese akakora anogona kuona kupisa, uye anopisa nekuburitsa simba. Dziviriro yeHarvard University yakawana kuti iyi yekudziya inoenderana nemapuroteni anonzi coupling protein - 1. Kana muviri uchiratidzwa kuchitonhora, huwandu hwekubatanidza protein-1 zvakapetwa.

Mumamiriro ezvinhu akajairika, varwere vanofanirwa kutsanya kwemaawa gumi nemaviri vasati vavhiyiwa. Kana kusimba kwavo kwemuviri kuri murombo, ivo vanozove vanonzwisa tsitsi zvakanyanya kukurudzira, zvichikonzera kuramba kwakanetesa. Iko kutonhora kusimudzira kunokonzerwa nekuvhiyiwa kunogona kukonzera kupisa kwemuviri kuti ubate.

C. State Pfungwa

Iko kushushikana kwepamoyo kwekutya kwakadai sekutya, kushushikana, uye kusagadzikana kukonzera kuti ropa rivezve, richikanganisa kudzoka kweropa kusvika pamoyo, uye zviri nyore kukonzera hypothermia panguva yekuvhiya.

D. Kurwara Kwakakosha

Inotsoropodza kurwara, yakasvibiswa zvakanyanya: yakaderera kupisa kwekugadzira simba.

Akaremara kutendeka kweganda: Huru trauma, maronda akanyanya, anopisa.

(Ii) zvakatipoteredza

Tembiricha mukamuri rekushandisa rinowanzotongwa pamwe chete 21-25 ° C. pazasi tembiricha yemuviri.

Iko kujairika tembiricha yeLomar kuyerera imba yekuenda uye kukurumidza kuiswa kwemweya wemukati kuchawedzera kuparadzaniswa kwemuviri wemurwere, izvo zvinokonzeresa tembiricha yemurwere kuti idonhedze.

(Iii) muviri unopisa kupaza

A. Ganda rekutadza:

Tembiricha yeiyo disinceptant yakaderera, uye chinangwa chekusatyoka chinogona kungowanikwa mushure mekusafara kwacho. Iko kusungwa kweiyo disinfectant inotora kupisa kwakawanda kupisa uye inoderedza tembiricha yemuviri.

B. Kubhururuka Kunorema:

Kushambidza nehuremu hukuru hwenzvimbo yakajairwa kana mvura yejekiseni panguva yekushanda inotungamira zvakare kupisa kwemuviri, icho chiri chikonzero chekupisa kwemuviri kudonha.

C. Kuvhiya kukuru kunotora nguva yakareba, uye iyo nguva yekufumurwa yechipfuva uye dumbu nhengo dzakareba

D. Vashandi vekurapa vanoshaya kuziva kwekushisa kwekuchengetedza

Iv.anesthesia

Zvinodhaka zvinogona kushandura iyo yakatarwa nzvimbo yeiyo thermooreglory Center.

General Anesthesia - akawanda anesthetics anogona kunyudza zvakananga mitsipa yeropa, uye kusununguka kwemasuru kunogona kudzivirira mhinduro yekubvunda.

Regional Block Anesthesia - Iyo inodiviwa yemukati yemheremhere yekutonhora inotonhora yakadzivirirwa, kuitira kuti nzvimbo yacho itendire kuti nzvimbo yakadzivirirwa inodziya.

V. Fluid uye kuwedzerwa ropa

Influsion yehuwandu hukuru hwemvura uye stock ropa pane imwechete yemakamuri tembiricha kana huwandu hwakawanda hwekupenya kwemvura panguva yekuvhiya kwekuvhiya

Intravenous incuusion of 1l yemvura pamhepo tembiricha kana 1 unit yeiyo 4c ropa mune vakuru vanogona kuderedza tembiricha yemuviri neinenge 0,25 ° C.

Kubuda kubva: Wu Zhimin. Yue Yuan. Tsvagurudzo uye mukoti we hypothermia panguva yekuvharira kweropa anesthesia inoshanda]. ChiChinese Chinyorwa cheanoshanda Nursoti, 2005